Search PubMed⌕ Search

Biomedical subjects

G Lorette

Publications and source records attributed to G Lorette.

At least 19 recordsLinked to original sources
PubMed1999

Leg ulcers and hydroxyurea: forty-one cases.

BACKGROUND: Hydroxyurea is an antitumor agent used to treat chronic myeloproliferative disorders. Leg ulcerations have been reported in patients undergoing long-term hydroxyurea therapy for myeloproliferative diseases. To better define this dermatological adverse effect of hydroxyurea therapy and to try to understand the pathophysiological process of this disease, we collected medical information for such patients in a multicenter retrospective study. OBSERVATIONS: Forty-one patients (mean age, 67 years) developed leg ulcerations while undergoing hydroxyurea therapy (mean therapy duration, 5 years). The sex ratio was 1, and there was no underlying vascular disease. Hematologic abnormalities were identified. Complete recovery from the ulcerations occurred quickly after withdrawal of treatment in 33 (80%) of the cases. CONCLUSIONS: This longest-reported series of patients confirms the role of hydroxyurea therapy in the onset of leg ulcerations. Healing or improvement requires cessation of treatment. Cutaneous atrophy and impaired wound healing may explain the relationship between hydroxyurea and leg ulcers. In addition, the megaloblastic erythrocytes resulting from the presence of hydroxyurea may circulate poorly through the capillary network. A prospective study in hematologic centers would be valuable.

Adult↗
PubMed1999

Bone involvement in a case of Kaposi sarcoma.

BACKGROUND: Extracutaneous involvement is rare in the classical form of Kaposi sarcoma (KS). OBSERVATION: We report a case of bone involvement revealed by bone pain. Magnetic resonance (MR) images demonstrated the local invasion of bone from cutaneous lesions. Bone biopsy confirmed bone involvement. The patient was treated with vindesine. Bone pain progressively disappeared. CONCLUSION: Bone involvement has rarely been reported in classical KS though 4.5% of the patients were affected when it was systematically sought. Treatment of symptomatic lesions requires radiotherapy or chemotherapy.

Aged↗
PubMed1999

[Cutaneous periarteritis nodosa: diagnostic and therapeutic aspects of 9 cases].

BACKGROUND: Cutaneous periarteritis nodosa (PAN) is distinguished from systemic PAN by the lack of visceral involvement. The aim of this study was to describe the clinical presentation, laboratory findings, clinical course, and treatment in cutaneous PAN. PATIENTS AND METHODS: We retrospectively reviewed the files of patients hospitalized for vasculitis in our Dermatology unit where approximately 20 cases of vasculitis are seen each year. Inclusion criteria were skin signs suggestive of PAN and a histological image of leukocytoclastic vasculitis of an arteriole. RESULTS: Nine cases of cutaneous PAN were treated in our unit between 1976 and 1997. Follow-up ranged from 32 months to 22 years. No cases of systemic PAN had been diagnosed during this period. These 9 cases of cutaneous PAN all had the same clinical presentation: nodules on the lower limbs in all cases associated with nodules on the upper limbs in half of the cases. Neuropathy was found in 3 of the 9 cases. No systemic involvement was observed. The most frequently used treatment protocol was general corticosteroid therapy (0.5 mg/kg/d prednisone or prednisolone). Immunosuppressive drugs, colchicine, dapsone, non-steroidal anti-inflammatory drugs and intravenous immunoglobulins were also used with efficacy. DISCUSSION: Cutaneous PAN is a particular form of vasculitis associating skin signs with locoregional neuromuscular involvement. The differential diagnosis with other types of vasculitis is sometimes a difficult task. The clinical course is the fundamental diagnostic clue in cutaneous PAN. A benign course and the absence of visceral involvement allow initiating a symptomatic treatment such as colchicine. The development of neuromuscular signs may warrant the use of general corticosteroid therapy.

Adrenal Cortex Hormones↗
PubMed1999

[D-penicillamine-induced pemphigus, polymyositis and myasthenia].

BACKGROUND: D-penicillamine can induce autoimmune disease, particularly in patients with associated immune disorders. CASE REPORT: A 67-year old woman who had been taking D-penicillamine for 15 months for rheumatoid arthritis was hospitalized due to the development of a bullous eruption and proximal muscle deficiency. Search for intercellular antisubstance antibodies in serum was negative. The skin biopsy histology revealed intra-epidermal cleavage in the mucosal body and direct immunofluorescence revealed epidermal frame-marking with anti-IgG and anti-C3 antibodies. Other tests revealed muscular cytolysis, and anti-acetylcholine receptor antibodies. The electromyogram showed neuromuscular block without muscle deficiency and muscle biopsy showed moderate myositis. D-penicillamine was interrupted and was followed by cure of the pemphigus and aggravation of the myositis, requiring high-dose systemic corticosteroid therapy. DISCUSSION: This patient developed D-penicillamine induced pemphigus, a rather frequent observation. The desmoglein immunolabelling favored drug-induced pemphigus and the course was rapidly favorable after withdrawal. Pemphigus had developed simultaneously with signs of myasthenia and polymyositis. Polymyositis and myasthenia are also known complications of D-penicillamine therapy. The association of these three complications suggests that D-penicillamine can unmask certain antigens or have an immunomodulator effect.

Aged↗
PubMed1998

[Acquired tufted angioma in an adult: failure of pulsed dye laser therapy].

BACKGROUND: Tufted angioma, described by Wilson Jones in 1976, is a benign acquired vascular tumor occurring in children or young adults, usually located on the neck or the upper part of the thorax. Pathology examination confirms the diagnosis showing well-limited lobules in the dermis composed of tight clusters of capillaries without atypical cells. CASE REPORT: An 81-year-old woman consulted for a large extensive angiomatous lesion involving the neck and shoulder which had developed over two years. Histopathology reported tufted angioma. Treatment with pulsed dye laser was unsuccessful. DISCUSSION: Different treatments have been proposed for tufted angiomas: surgery, cryotherapy, interferon, argon laser and pulsed dye laser. This is a second cases of unsuccessful treatment, perhaps due to deep extension of the angioma.

Aged↗
PubMed1998

[Multiple congenital smooth-muscle hamartomas].

BACKGROUND: Smooth muscle hamartoma is an uncommon lesion. Diagnosis is usually made at birth in infants presenting a plaque with minimal or no infiltration and covered with long dark hairs. Congenital forms with multiple plaques are rarely reported. CASE REPORT: A 5-day-old infant (normal pregnancy and delivery) had plaques localized on the buttocks, the left thigh, leg and shoulder and the right ankle. The plaques were minimally infiltrative and covered with long black hairs. Histology examination showed hyperplastic smooth muscle bundles with varying orientation. The diagnosis was smooth muscle hamartoma. The rest of the clinical examination was normal. CONCLUSION: This case of congenital smooth muscle hamartoma showed a particular form with partially regressive multiple plaques.

Biopsy↗
PubMed1998

[High resolution ultrasound imaging: value in treatment of basocellular carcinoma by cryosurgery].

OBJECTIVE: We conducted a prospective evaluation of the contribution of high-resolution ultrasound imaging prior to cryosurgery for basocellular carcinoma and in search for recurrence. PATIENTS AND METHODS: All patients seen between 1992 and 1994 at the skin tumor clinic and treated by cryosurgery were included. Ultrasound imaging using 20 MHz prototype was performed prior to cryosurgery and 2 months later. RESULTS: Among 101 patients treated, 112 basocellular carcinomas were treated by cryosurgery. Ultrasound imaging provided good visualization of the tumor limits in all cases. The ultrasound aspect was anechogenic, often with rare areas of highly dense echoes. The tumor limits described by ultrasound imaging were larger than the clinical limits in 32% of the cases. In 8 of the 16 cases of recurrent tumors, the ultrasound examination revealed the recurrence first. In the other 8 cases, clinical manifestations were confirmed by ultrasonography. In our series, recurrence of basocellular carcinoma was statistically more frequent when the depth of the tumor was 3 mm (ultrasonographic measurement) or when the lateral limits established by ultrasound assessment were greater than the clinical evaluation. DISCUSSION: These findings demonstrate that high-resolution ultrasound imaging of basocellular carcinomas prior to cryosurgery: 1) visualizes tumor limits allowing adapted cryosurgery, 2) identifies factors with predictive value for recurrence, 3) can identify recurrences early. Ultrasound imaging of the skin is a useful non-invasive technique for pre- and post-therapeutic assessment of skin tumors and could be a particularly useful tool for "blind" cryosurgery destruction of skin tumors.

Adult↗
PubMed1998

[Chronic radiodermatitis after heart catheterization: the contributing role of ciprofibrate (Lipanor)?].

BACKGROUND: Radiodermatitis after cardiac catheterization procedures has been reported in only a few cases in the literature. This side effect may not however be uncommon after long or repeated endocavitary explorations. CASE REPORT: We observed a case of chronic radiodermatitis which developed after cardiac catheterization, in a patient treated with corticosteroids and ciprofibrate for lupus. The patient had undergone only one heart catheterization. A second catheterization performed when the patient had stopped ciprofibrate did not provoke new lesions. DISCUSSION: This observations would suggest that ciprofibrate could participate as a radiosensitizing factor in the development of radiodermatitis.

Cardiac Catheterization↗